Aseptic intussuscepted incidental appendectomy: three successful cases

Background: Incidental appendectomy remains a controversial issue. We aimed to collect experience using a modified surgical technique that could be applied securely in infants. Methods: We performed aseptic intussuscepted incidental appendectomy (AIIA) in three patients using a technique that is thought to assure appendix necrosis along with intact cecal wall. Results: There was no perioperative morbidity due to AIIA in the three patients. In two infants the necrotic appendix was found in the diaper. One infant died secondary to diaphragmatic hernia. Autopsy with histological examination revealed that the cecum was intact along with appendix necrosis. Conclusions: Modified AIIA could securely be performed in the 3 reported cases. We advocate prospective evaluation of the metho

Aseptic intussuscepted incidental appendectomy: three successful cases

BACKGROUND: Incidental appendectomy remains a controversial issue. We aimed to collect experience using a modified surgical technique that could be applied securely in infants. METHODS: We performed aseptic intussuscepted incidental appendectomy (AIIA) in three patients using a technique that is thought to assure appendix necrosis along with intact cecal wall. RESULTS: There was no perioperative morbidity due to AIIA in the three patients. In two infants the necrotic appendix was found in the diaper. One infant died secondary to diaphragmatic hernia. Autopsy with histological examination revealed that the cecum was intact along with appendix necrosis. CONCLUSIONS: Modified AIIA could securely be performed in the 3 reported cases. We advocate prospective evaluation of the method

Evaluation of explorations and dilemma on confontation of congenital malformation of urinary system in children

In the first part of the study appear the scientific data and the axes of the research concerning the diseases of the urinary system and the problems they create with the possibility of prenatal screening and diagnosis and with small reference to the course of the confrontation. The material that the research was based on was in children that were hospitalized, so there was the possibility of evaluation of the data of the study and the final confrontation of the children -correct or wrongly- but with the relevant questionnaire was made efficacious that the most appropriate information should be taken, so as for the differential conflicts to be understood giving answers to very important scientific questions and because this is how the perception and the thought of which would be the best way of confronting the problem. The Bioethical matters will be understood from the answers of the questionnaire in which until now the Greek Society is formed in such a way that gives the whole rules that do not allow us the indifference in front of the coexisting problem. It seems that the potentials that the prenatal screening and diagnosis set us a fundamental bioethical dilemma and moreover it is for granted that in those cases there should not violate the commitment for respect to the primary and unique value of life no matter the form that this commitment has as concerning the ethical correct decision of the choice. Analyzing the results and evaluating the study of the medical record of the hospitalized children with congenital problem of the urinary system, there is a basic relation between the correct and defined time limits and age limits that has to be faced as concerning a disease and the interruption of gestation is in relation with ethics. That is changing as time passes by in relation with the results from the follow up after the delivery, the surgical intervention, the long term follow up and the almost normal growth of the child until the adult age.Στο πρώτο μέρος της μελέτης κατατίθενται τα υπάρχοντα επιστημονικά δεδομένα και οι άξονες της έρευνας σχετικά με τις παθήσεις του ουροποιητικού συστήματος και τα προβλήματα που μπορεί να δημιουργηθούν, με τις δυνατότητες του προγεννητικού έλεγχου και της διάγνωσης και με ελάχιστη αναφορά στην πορεία και τον σχεδιασμό της αντιμετώπισης. Το υλικό στο οποίο στηρίχθηκε η έρευνα είναι νοσηλευθέντα κατά το παρελθόν παιδιά, επομένως υπήρχε η δυνατότητα αξιολόγησης της μελέτης των νοσηλευτικών δεδομένων των παιδιών αυτών και της τελικής αντιμετώπισης της πάθησής των, ορθής ή λανθασμένης, ενώ με σχετικό ερωτηματολόγιο έγινε δυνατό να ληφθούν οι απαραίτητες και παράλληλα κατάλληλες πληροφορίες ώστε να γίνουν περαιτέρω κατανοητές οι διάφορες υπάρχουσες αντιδράσεις δίνοντας συλλογικά απαντήσεις σε σημαντικά ερευνητικά ερωτήματα. Από την ανάλυση των αποτελεσμάτων και από την αξιολόγηση της μελέτης των νοσηλευτικών ιστορικών των παιδιών με συγγενές πρόβλημα του ουροποιητικού, υπάρχει μια ουσιαστική σχέση μεταξύ της ορθής και εντός των καθορισμένων χρονικών και ηλικιακών ορίων αντιμετώπισης μιας πάθησης και η διακοπή της κύησης είναι συνάρτηση της διαμορφούμενης ηθικής του κοινωνικού συνόλου και τροποποιείται με την πάροδο του χρόνου σε συνάρτηση των αποτελεσμάτων από την κλινική και εργαστηριακή παρακολούθηση αμέσως μετά το τοκετό, την χειρουργική παρέμβαση, τη μακροχρόνια μετεγχειρητική παρακολούθηση και την κάπως φυσιολογική ανάπτυξη του παιδιού μέχρι αυτό να γίνει ενήλικας

Tunica Vaginalis Thickening, Hemorrhagic Infiltration and Inflammatory Changes in 8 Children with Primary Hydrocele; Reactive Mesothelial Hyperplasia? A Prospective Clinical Study

The aim of this study is to describe an entity of primary hydrocele accompanied with fibrosis, thickening and hemorrhagic infiltration of parietal layer of tunica vaginalis (PLTV). During a 4-year period (2011–2014), 94 boys (2.5–14 years old) underwent primary hydrocele repair. Hydrocele was right sided in 55 (58.5 %), left sided in 26 (28.7%) and bilateral in 12 patients (13.8%). Eighty three out of 94 patients (88.30%) had communicating hydrocele and the rest eleven patients (11.7%) had non-communicating. Our case group consists of 8 patients (8.51%) based on operative findings consistent with PLTV induration, thickening and hemorrhagic infiltration. Preoperative ultrasonography did not reveal any pathology of the intrascrotal structures besides hydrocele. There weren’t hyperechoic reflections or septa within the fluid. Evaluation of thickness of the PLTV was not feasible. Presence of lymph or exudate was excluded after fluid biochemical analysis. Tunica vaginalis histological examination confirmed thickening, hemorrhagic infiltration and inflammation, while there was absence of mesothelial cells. Immunochemistry for desmin was positive, excluding malignant mesothelioma. One patient underwent high ligation of the patent processus vaginalis and PLTV sheath fenestration, but one year later, he faced a recurrence. An elective second surgery was conducted via scrotal incision and Jaboulay operation was performed. The latter methodology was our treatment choice in other 7 out of 8 patients. During a 2-year postoperative follow-up, no other patient had any recurrence. We conclude that in primary hydrocele with macroscopic features indicative of tunica vaginalis inflammation, reversion of the tunica should be a part of operative strategy instead of sheath fenestration, in order to minimize the recurrence

A Bilateral, Non-syndromic, Type III Second Branchial Arch Sinus in a Neonate: a Case Report

The incidence of a second branchial arch sinus accounts for 26–60% of all existing congenital malformations deriving from the branchial apparatus. They are most usually detected between 14 months and 7 years of age, while their incidence during neonatal period and infancy accounts for 0.06% of all cases. The aim of this case study is to emphasize three rare characteristic features: the manifestation during neonatal period, the bilateral localization and the ultrasonographic diagnostic documentation. A 25 days old girl was admitted by her parents due to the presence of mucoid excretion from two small openings found on the neck. These openings were found bilaterally, between the mid and lower third of the anterior border of sternocleidomastoid muscle. Diagnosis was confirmed via ultrasonography. The patient underwent elective surgery during early infancy and both branchial fistulas were excised. Patient’s postoperative course was uneventful. In conclusion: – in cases of a bilateral second branchial arch sinus, the branchio-oto-renal (BOR) or branchio-otic (BO) syndromes must be excluded; – ultrasound scan can be used for the thorough evaluation of the sinus anatomic course and the relationship with the adjacent anatomic structures; – rompt diagnosis and early therapeutic intervention, even during neonatal period, ensures an uneventful post-operation course

Aseptic intussuscepted incidental appendectomy: three successful cases

BACKGROUND: Incidental appendectomy remains a controversial issue. We aimed to collect experience using a modified surgical technique that could be applied securely in infants. METHODS: We performed aseptic intussuscepted incidental appendectomy (AIIA) in three patients using a technique that is thought to assure appendix necrosis along with intact cecal wall. RESULTS: There was no perioperative morbidity due to AIIA in the three patients. In two infants the necrotic appendix was found in the diaper. One infant died secondary to diaphragmatic hernia. Autopsy with histological examination revealed that the cecum was intact along with appendix necrosis. CONCLUSIONS: Modified AIIA could securely be performed in the 3 reported cases. We advocate prospective evaluation of the method